PB2282: HERPESVIRUSES REPLICATION DURING COVID-19 IN NON-HODGKIN’S LYMPHOMA PATIENTS.
Authors: K. Sychevskaya, S. Kravchenko, D. Tikhomirov, A. Korneeva, A. Abdulpatahov, R. Abdurashidova, A. Keniaykina, Z. Sarakaeva, T. Tupoleva, A. Misyurina, F. Babaeva
Journal: HemaSphere (2022)

Background: At the moment, the association between COVID-19 and herpesvirus infection has been shown for herpes simplex virus-1 and 2 (HSV 1-2) and herpes zoster (HZ). However, publications are limited to clinical cases of herpes clinical manifestation before or in period of acute COVID-19. So the problem is not sufficiently disclosed. Activation of other types of herpes viruses, as well as the frequency of asymptomatic replication have not been studied at all. Aims: To study the probability of herpesviruses reactivation during COVID-19 via analyzing the frequency of HSV1-2, cytomegalovirus (CMV), Epstein-Barr virus (EBV) and human herpes virus 6 (HHV6) replication in patients with PCR-proven COVID-19 infection and concomitant non-Hodgkin’s lymphomas (NHL). Methods: The study included 15 NHL patients with PCR-proven COVID-19. During the period of positive DNA SARS-CoV-2 test preservation the PCR replication of herpesviruses DNA (HSV1-2, CMV, EBV, HHV6) in biological fluids (blood, saliva, urine) was studied. Results: In all patients, COVID-19 manifested after chemotherapy cycle. Our cohort was treatment heterogeneous. The most frequent treatment options were R-DA-EPOCH or high-dose pulse immunochemotherapy. The frequency of herpesvirus DNA detection in at least one biological material was HSV1-2 – 20%, CMV – 13%, EBV – 20%, HHV6 – 47%, respectively. Total activation frequency of at least one herpesvirus was 80%. The clinical signs, mainly of viral stomatitis, were present only in 47% patients. In the same patient cohort herpesviruses replication in the history (before COVID-19), mainly during previous chemotherapy, was HSV1-2 33%, CMV 20%, EBV 33%, HHV6 67%, and overall 73%, respectively. Summary/Conclusion: According our results the frequency of herpesviruses replication in NHL patients during COVID-19 is as high as 80%. However, this was comparable with 73% herpesviruses persistence during previous chemotherapy. Also, there was no significant difference between DNA copies number in the same patients before and during COVID-19. Therefore, the presented data do not indicate the direct causal relationship between COVID-19 and herpesviruses reactivation since almost in all cases there was a history of herpesvirus infection before. In addition, we should take in account the external chemotherapy trigger, equally potentiating both COVID-19 infection and herpesviruses reactivation. At the same time, our data are valuable as indicate high probability of parallell manifestation (for one reason or another) of COVID-19 and latent herpesvirus infection reactivation in NHL patients. So this fact should be considered in management of NHL patients with concomitant COVID-19. As we demonstrated subclinical herpesviruses replication without concomitant clinical signs, indicating underestimation of the real frequency herpesviruses reactivation in NHL patients with COVID-19, complex diagnostic approach is required including DNA herpesviruses evaluating. Neurological complications common after COVID-19 are predominantly referred to the direct neurotoxic effect of SARS-CoV-2. However, in the light of the presented data, we should not forget the possible concomitant herpetic neuropathy as the cause of neurological failure.